Anxiety is increasingly recognized as a major health issue among university students, exacerbated by academic pressure, financial stress, social isolation, and an uncertain job market. Despite its prevalence, many students do not seek help due to a lack of awareness, fear of judgment, or uncertainty about available resources. A recent study published in BMC Nursing by researchers from the University of Coimbra and the University of Porto aims to address this gap through a mental health literacy program focused on anxiety in the student population.
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Led by Andreia Sofia Cristina and supported by Inês Franco de Almeida, Carlos Alberto Cruz Sequeira, and Amorim Gabriel Santos Rosa, the research emphasizes the importance of mental health literacy (MHL). This concept involves understanding and recognizing mental disorders, accessing treatment, and developing attitudes that diminish stigma. Low levels of MHL can lead to misinterpretation of symptoms as personal weakness, which can delay seeking help and worsen conditions.
While existing mental health literacy programs are available, most do not specifically address anxiety and are not co-created with the target demographic. This new program differentiates itself by incorporating student input from the very beginning. In the first phase, 19 students participated in focus groups to share their experiences related to anxiety and mental health. The feedback gathered through these discussions was crucial, as it ensured that the program was relevant and relatable to students’ real-life experiences.
From the focus groups, the team identified six core domains that shaped the program’s framework. Although not detailed in the abstract, the program aims to improve recognition of anxiety symptoms, enhance self-regulation skills, reduce stigma, and encourage help-seeking behaviors. The design targets specific manifestations of anxiety, such as physical symptoms that students might misinterpret.
The second phase involved a modified electronic Delphi study, a method traditionally used in health services research to achieve consensus among experts. In this study, 18 experts evaluated the program’s content and structure across two rounds of feedback. The Delphi approach yields a comprehensive evaluation by allowing anonymous contributions, which can help reveal both strengths and weaknesses. Most aspects of the program received strong agreement from the panel, but experts provided specific recommendations for improvement, including session duration and delivery format.
One area where consensus was not reached was the proposed eight-week duration of the program. Researchers plan to resolve this during pilot testing rather than forcing an agreement prior to implementation, acknowledging that the ideal duration may vary based on several factors such as participant engagement and academic demands.
The developed program is designed to be both structured and flexible, enabling university counseling services and health professionals to adapt it to local contexts while maintaining its core components. Emphasizing the role of nurses in campus mental health, the program positions them as key figures in promoting mental health, rather than as support staff.
Having completed the content validation phase, the program now advances to pilot testing to assess its feasibility, acceptability, and preliminary effectiveness. This next stage will gather data on whether the program can be implemented effectively within academic calendars and whether student participation is sustained. By validating its impact on symptom recognition and help-seeking behaviors, the initiative could serve as a valuable tool for universities to tackle one of the most common yet under-addressed mental health challenges faced by students.